title: Management of subaxial cervical facet dislocation through anterior approach monitored by spinal cord evoked potential.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To discuss the clinical efficacy of anterior cervical surgery of decompression, reduction, stabilization, and fusion in treating subaxial cervical facet dislocation without spinal cord injury or with mild spinal cord injury monitored by spinal cord evoked potential.
  
  
  BACKGROUND
  The optimal treatment of lower cervical facet dislocation has been controversial. Because of the risk of iatrogenic damage of neurological function, it is challenging for surgeons to manage the lower cervical facet dislocation without or with mild spinal cord injury. To avoid the risks, more secure strategy need to be designed.
  
  
  METHODS
  A retrospective study was performed on 17 cases of subaxial cervical facet dislocation without spinal cord injury or with mild spinal cord injury treated by anterior cervical surgery under spinal cord evoked potential monitor from January 2008 to June 2012. There were 12 males, 5 females, with a mean age of 40.1 years (from 21 to 73 yr). Dislocation sites: 1 in C3-C4, 2 in C4-C5, 6 in C5-C6, 8 in C6-C7; 10 cases with unilateral cervical facet dislocation, 7 cases with bilateral dislocation. Thirteen patients were preoperatively classified as grade D and 4 as E according to Frankel standard. All patients were followed up for average of 16 months.
  
  
  RESULTS
  All operations were completed successfully. Postoperative radiographs showed that the sequence and curvature of the cervical spine were well recovered. And, evidence of intervertebral fusion was observed at 3 months in all cases. No redislocation or symptoms of spinal cord injury occurred. Thirteen cases with mild spinal cord injury recovered at 1 month after operation.
  
  
  CONCLUSIONS
  Anterior cervical surgery of decompression, reduction, stabilization, and fusion monitored by spinal cord evoked potential is an effective and safe method for treatment of subaxial cervical facet dislocation without or with mild spinal cord injury.
  
  
  METHODS
  4.
authors.affiliation: *Department of Orthopedic Surgery, Qilu Hospital, Shandong University, Jinan, P.R. China; and †Department of Spine Surgery, Yantaishan Hospital, Yantai, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Du
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Jiangwei
authors.initials: J
authors.lastname: Tan
authors.forename: Binghua
authors.initials: B
authors.lastname: Shen
authors.forename: Shuqin
authors.initials: S
authors.lastname: Ni
authors.forename: Yanping
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology*; D013123:Spinal Fusion; D016896:Treatment Outcome; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000293:injuries* / Q000601:surgery